Basic Information
| Provider Information | |||||||||
| NPI: | 1295239218 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POYNER | ||||||||
| FirstName: | HANNAH | ||||||||
| MiddleName: | |||||||||
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| Credential: | FNP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BOATWRIGHT | ||||||||
| OtherFirstName: | HANNAH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 517 CITY AVE S | ||||||||
| Address2: | |||||||||
| City: | RIPLEY | ||||||||
| State: | MS | ||||||||
| PostalCode: | 38663 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 517 CITY AVE S | ||||||||
| Address2: | |||||||||
| City: | RIPLEY | ||||||||
| State: | MS | ||||||||
| PostalCode: | 38663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6625878206 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2018 | ||||||||
| LastUpdateDate: | 09/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 902567 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.